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Hospitalization With Clostridioides difficile in Pediatric Inflammatory Bowel Disease: a Population-Based Study

OBJECTIVES: Several studies have demonstrated higher rates of Clostridioides difficile infection (CDI) in adults with inflammatory bowel disease (IBD). We conducted a population-based study comparing the risk of hospitalization with CDI in children with and without IBD. METHODS: Using health adminis...

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Autores principales: Kuenzig, M. Ellen, Benchimol, Eric I., Bernstein, Charles N., Bitton, Alain, Carroll, Matthew W., Griffiths, Anne M., Kaplan, Gilaad G., Nguyen, Geoffrey C., Otley, Anthony R., Stukel, Therese A., Dummer, Trevor J.B., El-Matary, Wael, Jacobson, Kevan, Jones, Jennifer L., Lix, Lisa M., Mack, David R., Murthy, Sanjay K., Peña-Sánchez, Juan-Nicolás, Targownik, Laura E., Fung, Stephen G., Spruin, Sarah, Coward, Stephanie, Cui, Yunsong, Filliter, Christopher, Nugent, Zoann, Siddiq, Shabnaz, Singh, Harminder
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9278713/
https://www.ncbi.nlm.nih.gov/pubmed/35675701
http://dx.doi.org/10.1097/MPG.0000000000003489
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author Kuenzig, M. Ellen
Benchimol, Eric I.
Bernstein, Charles N.
Bitton, Alain
Carroll, Matthew W.
Griffiths, Anne M.
Kaplan, Gilaad G.
Nguyen, Geoffrey C.
Otley, Anthony R.
Stukel, Therese A.
Dummer, Trevor J.B.
El-Matary, Wael
Jacobson, Kevan
Jones, Jennifer L.
Lix, Lisa M.
Mack, David R.
Murthy, Sanjay K.
Peña-Sánchez, Juan-Nicolás
Targownik, Laura E.
Fung, Stephen G.
Spruin, Sarah
Coward, Stephanie
Cui, Yunsong
Filliter, Christopher
Nugent, Zoann
Siddiq, Shabnaz
Singh, Harminder
author_facet Kuenzig, M. Ellen
Benchimol, Eric I.
Bernstein, Charles N.
Bitton, Alain
Carroll, Matthew W.
Griffiths, Anne M.
Kaplan, Gilaad G.
Nguyen, Geoffrey C.
Otley, Anthony R.
Stukel, Therese A.
Dummer, Trevor J.B.
El-Matary, Wael
Jacobson, Kevan
Jones, Jennifer L.
Lix, Lisa M.
Mack, David R.
Murthy, Sanjay K.
Peña-Sánchez, Juan-Nicolás
Targownik, Laura E.
Fung, Stephen G.
Spruin, Sarah
Coward, Stephanie
Cui, Yunsong
Filliter, Christopher
Nugent, Zoann
Siddiq, Shabnaz
Singh, Harminder
author_sort Kuenzig, M. Ellen
collection PubMed
description OBJECTIVES: Several studies have demonstrated higher rates of Clostridioides difficile infection (CDI) in adults with inflammatory bowel disease (IBD). We conducted a population-based study comparing the risk of hospitalization with CDI in children with and without IBD. METHODS: Using health administrative data and validated algorithms, we identified all children (<16 years) diagnosed with IBD in 5 Canadian provinces, then age and sex matched to 5 children without IBD. Province-specific 5-year incidence rates of hospitalization with CDI were pooled and generalized linear mixed-effects models were used to estimate the crude incidence rate ratio (IRR) comparing (1) children with and without IBD and (2) children with Crohn disease and ulcerative colitis. Hazard ratios (HR) from Cox proportional hazards models adjusting for age, sex, rural/urban household, and income were pooled using fixed-effects models. RESULTS: The incidence rate of CDI identified during hospitalization was 49.06 [95% confidence interval (CI), 39.40–61.08] per 10,000 person-years (PY) in 3593 children with IBD compared to 0.39 (95% CI, 0.13–1.21) per 10,000 PY in 16,284 children without IBD (crude IRR, 133.4, 95% CI, 42.1–422.7; adjusted HR, 68.2, 95% CI, 24.4–190.4). CDI was identified less often in children with Crohn disease than ulcerative colitis (crude IRR, 0.51, 95% CI, 0.32–0.82; adjusted HR, 0.69, 95% CI, 0.46–1.05). CONCLUSIONS: Children with IBD have a markedly higher incidence of CDI identified during a hospitalization relative to children without IBD. Consequently, symptomatic children with IBD who are hospitalized should be screened for CDI.
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spelling pubmed-92787132022-08-02 Hospitalization With Clostridioides difficile in Pediatric Inflammatory Bowel Disease: a Population-Based Study Kuenzig, M. Ellen Benchimol, Eric I. Bernstein, Charles N. Bitton, Alain Carroll, Matthew W. Griffiths, Anne M. Kaplan, Gilaad G. Nguyen, Geoffrey C. Otley, Anthony R. Stukel, Therese A. Dummer, Trevor J.B. El-Matary, Wael Jacobson, Kevan Jones, Jennifer L. Lix, Lisa M. Mack, David R. Murthy, Sanjay K. Peña-Sánchez, Juan-Nicolás Targownik, Laura E. Fung, Stephen G. Spruin, Sarah Coward, Stephanie Cui, Yunsong Filliter, Christopher Nugent, Zoann Siddiq, Shabnaz Singh, Harminder J Pediatr Gastroenterol Nutr Original Articles: Gastroenterology: Inflammatory Bowel Diseases OBJECTIVES: Several studies have demonstrated higher rates of Clostridioides difficile infection (CDI) in adults with inflammatory bowel disease (IBD). We conducted a population-based study comparing the risk of hospitalization with CDI in children with and without IBD. METHODS: Using health administrative data and validated algorithms, we identified all children (<16 years) diagnosed with IBD in 5 Canadian provinces, then age and sex matched to 5 children without IBD. Province-specific 5-year incidence rates of hospitalization with CDI were pooled and generalized linear mixed-effects models were used to estimate the crude incidence rate ratio (IRR) comparing (1) children with and without IBD and (2) children with Crohn disease and ulcerative colitis. Hazard ratios (HR) from Cox proportional hazards models adjusting for age, sex, rural/urban household, and income were pooled using fixed-effects models. RESULTS: The incidence rate of CDI identified during hospitalization was 49.06 [95% confidence interval (CI), 39.40–61.08] per 10,000 person-years (PY) in 3593 children with IBD compared to 0.39 (95% CI, 0.13–1.21) per 10,000 PY in 16,284 children without IBD (crude IRR, 133.4, 95% CI, 42.1–422.7; adjusted HR, 68.2, 95% CI, 24.4–190.4). CDI was identified less often in children with Crohn disease than ulcerative colitis (crude IRR, 0.51, 95% CI, 0.32–0.82; adjusted HR, 0.69, 95% CI, 0.46–1.05). CONCLUSIONS: Children with IBD have a markedly higher incidence of CDI identified during a hospitalization relative to children without IBD. Consequently, symptomatic children with IBD who are hospitalized should be screened for CDI. Lippincott Williams & Wilkins 2022-06-07 2022-08 /pmc/articles/PMC9278713/ /pubmed/35675701 http://dx.doi.org/10.1097/MPG.0000000000003489 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Articles: Gastroenterology: Inflammatory Bowel Diseases
Kuenzig, M. Ellen
Benchimol, Eric I.
Bernstein, Charles N.
Bitton, Alain
Carroll, Matthew W.
Griffiths, Anne M.
Kaplan, Gilaad G.
Nguyen, Geoffrey C.
Otley, Anthony R.
Stukel, Therese A.
Dummer, Trevor J.B.
El-Matary, Wael
Jacobson, Kevan
Jones, Jennifer L.
Lix, Lisa M.
Mack, David R.
Murthy, Sanjay K.
Peña-Sánchez, Juan-Nicolás
Targownik, Laura E.
Fung, Stephen G.
Spruin, Sarah
Coward, Stephanie
Cui, Yunsong
Filliter, Christopher
Nugent, Zoann
Siddiq, Shabnaz
Singh, Harminder
Hospitalization With Clostridioides difficile in Pediatric Inflammatory Bowel Disease: a Population-Based Study
title Hospitalization With Clostridioides difficile in Pediatric Inflammatory Bowel Disease: a Population-Based Study
title_full Hospitalization With Clostridioides difficile in Pediatric Inflammatory Bowel Disease: a Population-Based Study
title_fullStr Hospitalization With Clostridioides difficile in Pediatric Inflammatory Bowel Disease: a Population-Based Study
title_full_unstemmed Hospitalization With Clostridioides difficile in Pediatric Inflammatory Bowel Disease: a Population-Based Study
title_short Hospitalization With Clostridioides difficile in Pediatric Inflammatory Bowel Disease: a Population-Based Study
title_sort hospitalization with clostridioides difficile in pediatric inflammatory bowel disease: a population-based study
topic Original Articles: Gastroenterology: Inflammatory Bowel Diseases
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9278713/
https://www.ncbi.nlm.nih.gov/pubmed/35675701
http://dx.doi.org/10.1097/MPG.0000000000003489
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